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Note on Global Health

When 1/4 times 4 is greater than 1

Combination pills, especially for blood pressure, offer benefit to the patient in convenience, and studies have shown their clear benefit in treating hypertension. The approach tested in todayC’s Lancet release, goes even further, using small one-quarter doses of four commonly used generic anti-hypertensives. Containing just irbesartan 37·5 mg, amlodipine 1·25 mg, hydrochlorothiazide 6·25 mg, and atenolol 12·5 mg, the placebo-corrected office blood pressure decrease was 22/13. Side effects were minimal, as you would expect from such reduced doses. The advantage of an effective, low-cost, one-pill treatment that minimizes the need for titration is obvious. This approach would be useful in the US, and have even more impact in developing countries, where hypertension has become an increasing problem.

See article  abstract, and first page of Lancet commentary

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